Biological outdoes conventional synthetic DMARD for psoriatic arthritis
The use of biological disease-modifying antirheumatic drugs (bDMARD) is associated with a minimal disease activity (MDA) status and remission in patients with psoriatic arthritis (PsA) as compared to conventional synthetic (cs)DMARD, according to a recent study.
Additionally, it appears that Psoriatic Arthritis Disease Activity Score (PASDAS) ≤1.9 and MDA 7/7 are stringent remission criteria.
Researchers enrolled patients with PsA (n=109) categorized using the CASPAR criteria and with >6 months follow-up treated with first csDMARD and bDMARD. They assessed disease activity using composite indices tailored for PsA, such as the Disease Activity Index for Psoriatic Arthritis (DAPSA), clinical (c)DAPSA, PASDAS, MDA 5/7 and MDA 7/7.
Remission was identified by DAPSA and cDAPSA score ≤4, MDA 7/7, and PASDAS ≤1.9. MDA and low disease activity (LDA) criteria were identified by MDA 5/7, DAPSA score ≤14, cDAPSA score ≤13 and PASDAS <3.2.
Of the patients enrolled, 79 were receiving stable treatment with bDMARD and 30 with csDMARD.
In general, there were 28 patients (25.6 percent) in cDAPSA remission, 23 (21.1 percent) in DAPSA remission, 19 (17.4 percent) in MDA 7/7 and 13 (11.9 percent) in PASDAS ≤1.9. In addition, 54 patients (49.5 percent) were in MDA 5/7, 80 (73.3 percent) in DAPSA LDA, 79 (72.3 percent) in cDAPSA LDA and 38 (34.8 percent) in PASDAS LDA.
Compared with patients treated with csDMARD, those treated with bDMARD had significantly lower median DAPSA, cDAPSA and PASDAS score.
According to researchers, there are several methods available to define remission or LDA in a complex disease such as PsA.